For several decades now there have been various techniques in the field of surgery which seek to heal the patient through interventions which, in contrast with those referred to as open surgery, do not require giving the patient a large incision in order to act on the affected organs, thus allow rapid patient recovery, shorter hospitalization time and a lower risk for infections.
One of these techniques, which are usually comprised within the term “minimal invasion” or “minimally invasive surgery”, is arthroscopic surgery, which consists of performing surgical interventions without opening the patient up, making only a small incision referred to as portal, through which the instrument required for operating on a certain organ: bone, muscle, ligaments, etc., normally located in joints, will enter.
However, even though these types of operations have many advantages, they make it necessary for the medical staff that will be performing the intervention to be thoroughly prepared.
For this reason, and in order to achieve true-to-life training, a number of mechanical and/or virtual models have emerged which seek to train said medical staff as best possible so that these types of operations can be subsequently approached successfully.
These simulators, however, suffer the drawbacks of not being able to faithfully reproduce each and every one of the possible movements that the surgeon later needs to perform on the patient to carry out the intervention, such as for example the lateral movement referred to as varus-valgus movement when the leg of the patient is flexed, which is impossible to do if the leg is extended, traction or distension movement, or even mere articular movement.
Furthermore, said simulators in most cases are also not able to assess force exerted by the surgeon, or to feed back in the haptic devices that the surgeon handles the opposition exerted by the internal organs of the patient, so it is impossible to determine if the training is being performed suitably, or in other words, if said surgeon is appropriately learning the different techniques which will later be necessary to carry out in the intervention on the patient.
Even though other simulators reproduce therein the articular structure corresponding to the femur and the tibia, they have the drawback of said articulation occupying a large part of the cavity, leaving no free space therein for the movement of the haptic instrument, and therefore, they are unable to faithfully reproduce the conditions of a real arthroscopic operation.
U.S. Pat. No. 4,605,373 is known, describing a training device for handling fractured limbs by quantifying the movements applied to the leg. However, the inner part of the joint is not hollow and is not designed for the interior to be examined virtually, but rather for only evaluating the movements applied from the outside. It does not limit the varus-valgus movement and does not transmit force reactions.
Finally, patent US 2004/0254771 A1 describes a joint simulator which physically simulates various structures of the knee but it does not allow the penetration of instruments for simulating arthroscopic operations. Both the movements and the reflection of forces occur due to external actuators (robotic arm linked to the articulation) and not due to the articulation mechanism itself.